| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E2609 |
Custom fabricated wheelchair seat cushion, any size |
1,342 |
1,168 |
$1.08M |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
486 |
436 |
$816K |
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
95 |
67 |
$636K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
2,316 |
1,838 |
$630K |
| K0005 |
Ultralightweight wheelchair |
363 |
324 |
$602K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
1,445 |
1,111 |
$468K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,468 |
1,224 |
$271K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
1,689 |
1,437 |
$232K |
| E2311 |
Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware |
119 |
84 |
$220K |
| K0040 |
Adjustable angle footplate, each |
1,899 |
1,549 |
$218K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
403 |
356 |
$182K |
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
39 |
25 |
$172K |
| E2617 |
Custom fabricated wheelchair back cushion, any size, including any type mounting hardware |
212 |
195 |
$150K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
710 |
558 |
$112K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,230 |
1,037 |
$90K |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
36 |
26 |
$58K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
314 |
263 |
$55K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
139 |
100 |
$52K |
| E1002 |
Wheelchair accessory, power seating system, tilt only |
15 |
15 |
$48K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
137 |
99 |
$40K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
1,153 |
977 |
$33K |
| E2203 |
Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches |
76 |
65 |
$30K |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
220 |
191 |
$30K |
| E2359 |
Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
88 |
57 |
$28K |
| E1225 |
Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each |
37 |
37 |
$16K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
312 |
272 |
$13K |
| E2310 |
Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware |
13 |
13 |
$11K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
26 |
24 |
$9K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
139 |
116 |
$5K |